Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13385LMPNP	EZETIMIBE + SIMVASTATIN ezetimibe 10 mg + simvastatin 10 mg tablet, 30 (PI, CMI)	2	60	5	$30.15	$31.60	$31.60
	Available brands
	APO-Ezetimibe/Simvastatin 10/10a
	EZETIMIBE/SIMVASTATIN SANDOZa
	EZETIMIBE/SIMVASTATIN-WGR 10/10a
	EZETORINa
	EzSimva GH 10/10a
	Pharmacor Ezetimibe Simvastatin 10/10a
	Vytorina
	Zeklen 10/10 mga
	Zimybe 10/10a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13442LMPNP	EZETIMIBE + SIMVASTATIN ezetimibe 10 mg + simvastatin 20 mg tablet, 30 (PI, CMI)	2	60	5	$30.99	$31.60	$31.60
	Available brands
	APO-Ezetimibe/Simvastatin 10/20a
	EZETIMIBE/SIMVASTATIN SANDOZa
	EZETIMIBE/SIMVASTATIN-WGR 10/20a
	EZETORINa
	EzSimva GH 10/20a
	Pharmacor Ezetimibe Simvastatin 10/20a
	Vytorina
	Zeklen 10/20 mga
	Zimybe 10/20a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13535JMPNP	EZETIMIBE + SIMVASTATIN ezetimibe 10 mg + simvastatin 40 mg tablet, 30 (PI, CMI)	2	60	5	$32.17	$31.60	$31.60
	Available brands
	APO-Ezetimibe/Simvastatin 10/40a
	EZETIMIBE/SIMVASTATIN SANDOZa
	EZETIMIBE/SIMVASTATIN-WGR 10/40a
	EZETORINa
	EzSimva GH 10/40a
	Pharmacor Ezetimibe Simvastatin 10/40a
	Zeklen 10/40 mga
	Zimybe 10/40a
	Vytorina * Additional charge for this brand is $4.00B	2	60	5	$36.17	$31.60	$35.60

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13595MMPNP	EZETIMIBE + SIMVASTATIN ezetimibe 10 mg + simvastatin 80 mg tablet, 30 (PI, CMI)	2	60	5	$33.83	$31.60	$31.60
	Available brands
	APO-Ezetimibe/Simvastatin 10/80a
	EZETIMIBE/SIMVASTATIN SANDOZa
	EZETIMIBE/SIMVASTATIN-WGR 10/80a
	EZETORINa
	EzSimva GH 10/80a
	Pharmacor Ezetimibe Simvastatin 10/80a
	Zeklen 10/80 mga
	Zimybe 10/80a
	Vytorina * Additional charge for this brand is $4.00B	2	60	5	$37.83	$31.60	$35.60